Organization Active NPI

Broken Arrow Endodontics

  • Endodontics
  • Broken Arrow, OK
National Provider Identifier
1124219274
Registry record updated Oct 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
License
47 Issued in OK
Legal business name
BROKEN ARROW ENDODONTICS
Doing business as
Broken Arrow Endodontics
Practice address
4420 W Houston St
Broken Arrow, OK 74012-4645
Phone
(918) 615-3600
Fax
(918) 615-3601
NPI assigned
Aug 5, 2007
Last updated
Oct 27, 2020By the provider in NPPES
Organization subpart
Yes
Parent organization
BROKEN ARROW ENDODONTICSAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 27, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Eve G Strand
Title
Office Manager
Phone
(918) 615-3600

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endodontics 1223E0200X 47 OK Primary

Addresses

Primary practice location

4420 W Houston St
Broken Arrow, OK 74012-4645

Mailing address

4420 W Houston St
Broken Arrow, OK 74012-4645
Phone (918) 615-3600

Other names 1

  • Broken Arrow Endodontics Doing business as

National Provider Directory

National Provider Directory
Part of
Broken Arrow Endodontics

Locations

4420 W Houston St
Broken Arrow, OK 74012
Phone (918) 615-3600

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1186272000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1603756800000",
    "number": "1124219274",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4420 W HOUSTON ST",
            "city": "BROKEN ARROW",
            "state": "OK",
            "postal_code": "740124645",
            "telephone_number": "918-615-3600",
            "fax_number": "918-615-3601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4420 W HOUSTON ST",
            "city": "BROKEN ARROW",
            "state": "OK",
            "postal_code": "740124645",
            "telephone_number": "918-615-3600",
            "fax_number": "918-615-3601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BROKEN ARROW ENDODONTICS",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BROKEN ARROW ENDODONTICS",
        "enumeration_date": "2007-08-05",
        "last_updated": "2020-10-27",
        "certification_date": "2020-10-27",
        "status": "A",
        "authorized_official_last_name": "STRAND",
        "authorized_official_first_name": "EVE",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "918-615-3600"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "OK",
            "license": "47",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Broken Arrow Endodontics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Broken Arrow, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.